| Objective: olfactory groove meningiomas are slow-growing tumors with hidden symptoms.The tumors are huge at the time of treatment,which poses great challenges to surgeons..Although surgical techniques have been significantly developed,the optimal surgical scheme is still controversial.This study mainly describes the clinical characteristics of these lesions,analyzes the results of microsurgery treatment of olfactory groove meningiomas and the factors affecting tumor recurre nce.Looking for a more beneficial solution for patients.Methods: we retrospectively analyzed the course records,surgical records,neuroimaging examinations,pathological reports and follow-up results of 55 olfactory groove meningiomas patients who were diagnosed and underwent microsurgical resection in the first affiliated hospital of guangxi medical university from 2012 to 2019.Bilateral subfrontal and unilateral subfrontal approaches were used for microsurgical resection of olfactory groove meningiomas.Intraoperative resection and postoperative MRI examination were used to evaluate whether there were tumor remnants after surgery,and Simpson scale was used to evaluate the degree of resection.The relationship between surgical approach and tumor size,degree of tumor resection,incidence of complications,length of hospital stay,intraoperative blood loss,operation time,and Karnofsky’s functional status(KPS score)at discharge was analyzed,and the factors related to tumor recurrence,such as age,gender,and imaging characteristics were discussed.Tumor size and age were divided into two categories: small and medium-sized tumors ≤4cm,and large tumors were defined as > 4cm.Age ≤50 years old or age > 50 years old.Results: In this study,the most common symptoms were 37 cases(67.2%)of nonspecific headaches,followed by different degrees of olfactory disturbance 21(38.2%)and dizziness 19(34.5%),most of the symptoms could be improved after surgery.Simpson grade Ⅰ resection was performed in 12 patients(21.9%),Simpson grade Ⅱ resection in 32 patients(58.1%),Simpson grade Ⅲ resection in 6 patients(10.9%),and Simpson grade Ⅳ resection in 5 patients(9.1%).90%of tumors were completely removed.The most common postoperative complications were anosmia in 16 cases(29.1%),followed by pneumonia in 13cases(23.6%),intracranial infection in 12 cases(21.8%),hemorrhage in 5 cases(9.1%),frontal lobe injury in 6 cases(10.9%),cerebrospinal fluid leakage in 3cases(5.5%),brain swelling in 2 cases(3.6%),hypophysis in 1 case(1.8%),and no death in perioperative period.The patients were followed up for 6-94 months,with an average of 47.25 months,and 5 patients(9.10%)had tumor recurrence.Most patients recover well and can live alone or return to work.Our data analysis showed that the hospitalization time,operation time,intraoperative blood loss,postoperative complications(anosmia,cerebrospinal fluid leakage,frontal lobe injury)were different between the unilateral and bilateral subfrontal approach(P< 0.05),but there was no difference in the degree of surgical resection and KPS score at discharge(P>0.05).Paranasal sinus invasion and Simpson grade Ⅲ-Ⅳ resection were significantly associated with tumor recurrence(P<0.05).Conclusion: The unilateral subfrontal approach can remove olfactory groove meningiomas of different sizes under relatively safe conditions,and has the advantages of good curative effect,less bleeding,less complications,short operation time and hospital stay.Patients with paranasal sinus invasion and Simpson grade Ⅲ-Ⅳ resection have a higher tumor recurrence rate. |
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